Are we winning against maternal and infant mortality?

The mood at the conference on maternity and child survival in Mexico City is buoyant [Rebecca Blackwell/AP]

Mexico City - In South Africa, about 4,300 mothers die due to complications of pregnancy and childbirth every year. A further 20,000 babies are stillborn and another 23,000 die in their first month of life. In total, 75,000 children do not make it to their fifth birthday.

But the problem is not unique to South Africa. The death of new mothers and infants below the age of five is the single, biggest source of gender inequality in the world.

Researchers and activists say that despite the challenges, the tide has turned in the struggle to improve the health of mothers and infants across the globe. The last 30 years, and the last decade in particular, have yielded tremendous gains.

And Mexico is said to be among the biggest success stories.

With one of the larger health budgets in the developing world, Mexico has managed to outdo the likes of Nigeria and South Africa with its gains against maternal and infant mortality.

Likewise, Rwanda and Ethiopia have been lauded for their successful interventions in reducing the rates of maternal and infant deaths.

"I think Rwanda has been really good at using information to drive quality improvement," Chris Elias, president of Global Development at the Bill and Melinda Gates Foundation said.

"Like Ethiopia, they have been very successful in having a clear national plan and then convincing the development partners to align around a national plan with a strong monitoring and evaluation effort," he told journalists at a roundtable event at the conference.

Life expectancy

Significant gains have been made in global health. Worldwide, life expectancy has increased to 71, and global health for mothers and infants has also improved despite the overwhelmingly obvious shortfalls.

There is, however, still much to do.

Whereas 17 million children under five years of age died annually in 1970, this number has reduced to around 5.9 million today.

Both China and India have made progress, whereas countries like the Democratic Republic of Congo continue the struggle to make in-roads in the face of ongoing conflict, poor infrastructure and weak governance.

"The countdown to 2015 Report", the final instalment in a series of reports focused on global maternal health and child survival that began in 2005, was released late on Monday night at the conference and found that under-five mortality has dropped by 53 percent since 1990.

It also found the rate of reduction in deaths had accelerated over recent years. But children are still malnourished and dying from pneumonia and diarrhoea - both preventable and treatable conditions. Undernutrition and sub-optimum breastfeeding remains the cause of death of about 45 percent of children under five globally.

Family planning

The report also showed that in some countries, there remained significant opposition to contraceptives and family planning, both crucial indicators in assessing the extent to which women are in control of their destinies.

Zulfiqar Bhutta, codirector of Robert Harding Chair in Global Child Health and Policy, and cochairman of The Countdown Report, told Al Jazeera that successes and failures of countries to meet the fourth and fifth goals of the United Nation's Millennium Development Goals (MDGs), targeting infant and maternal mortality, were linked to a number of social determinants.

The landmark report showed that only four out of the 75 countries - identified for hosting 90 percent of all maternal and infant deaths across the planet - managed to successfully reach their respective MDGs forreducing maternity and infant deaths.

But the overwhelming failure of so many countries to meet these targets makes the success of Eritrea, Rwanda, Cambodia and Nepal in meeting their goals quite extraordinary.

"It all boils down to a combination of political will, which is, in turn, dictated by civil society pressure. If people in the country are just not focused on issues of rights, reducing inequities, [and] reaching marginalised populations we could cry hoarse from the outside, but it would make no difference," Bhutta said.